History of Lipo-Flavonoid and Citrus Bioflavonoids
More Than 50 Years of Clinical Experience.
Although the use of Lipo-Flavonoid® supplementation to address ringing in the ears is common among ear nose and throat specialists (“ENTs”) in modern medical practice1, this therapy was virtually unknown before 1962. The professional acceptance of this course of therapy was not built by television advertising or promotion by the sales force of a large pharmaceutical company. Rather, clinical observation by prominent ENT clinicians, duly reported in the medical literature, created a slow, and, sometimes grudging, acceptance of this treatment regimen by the professional ENT community.
Although sometimes mistakenly identified as the “creator” of the product2, Dr. Henry L. Williams, a prominent ENT on the staff of a Minnesota Clinic is credited with the insight that citrus bioflavonoids might be useful in treatment of patients with Meniere’s syndrome (frequently associated with the phenomenon of ringing in the ears). In a published 1962 “preliminary report” of a Staff Meeting, Williams and Hedgecock reported on a 122 patient study3 where Williams’ focus was on “citrus bioflavonoids.” In 1963, Williams, in an additional published study4, recognized that the key was not citrus bioflavonoids, but the specific bioflavonoid eriodictyol glycoside, contained in Lipo-Flavonoid® (found in lemons but not in other citrus). Dr. Williams’ work was pivotal in the ENT community and early adopters followed his example5.
Dr. Williams’ findings and experience were not always immediately embraced by the ENT community. An article written by Dr. Daniel Fahey published in The Laryngoscope in 1967 illustrates the skepticism6:
“Dr. Williams reported on Lipo-Flavonoid in 1962. Even though I was skeptical at first, I decided to use this. I hesitated due to the expense to the patient and the conflicting reports on its success; however I am now convinced of its value.
Since using Lipo-Flavonoid, the speed of resolution of symptom seems definitely reduced. Many patients, on tapering the dose after a few months, have a symptom recurrence; however, when they step up the dose, they improve again.”
In 1969, R.J. Wolfson (U. of Pennsylvania Medical Center) observed that:
…”Recently, Lipo-Flavonoid has been introduced for use in Meniere’s disease. This drug consists of a lemon bioflavonoid complex combined with a mixture of B vitamins. There have been several reports which indicate beneficial results. The value of the compound is attributed primarily to the action of the lemon bioflavonoid complex. Clinical experience indicates that a number of patients experience considerable benefit from this drug7 and there has (sic) been no adverse side-effects.8
The pattern established by these opinion leaders in the ENT community continued through the second half of the twentieth century at geographically diverse medical centers focused on ENT practice. In 1973 Rubin theorized that “the use of eriodictyol glycoside (bioflavonoids) is possibly based improving vascular permeability.”9 In 1975, Shaia and Sheehy described supplementation with Lipo-Flavonoid® as “…part of our routine medical therapy and is rarely omitted.”10
ENTs have recognized that most non-surgical treatment advances in addressing Meniere’s syndrome arise from observation of trained clinicians who are willing to share their experience with peers by publishing their clinical observations. See, for example, Slattery & Fayad (1997):
“Nonsurgical treatment of Meniere’s disease is considered effective in approximately 80% of Meniere’s disease patients and forms the primary therapy in managing these patients…Most medical therapy [for Meniere’s] is based on clinical experience and many medications were discovered serendipitously.”11
In 2010 the manufacturers of Lipo-Flavonoid® commissioned an independent study of practicing ENTs. More than 50% reported that they recommended dietary supplements to patients complaining of ringing in the ears. In more than 90% of the cases the specific brand recommended was Lipo-Flavonoid®. In April 2018 another independent survey of 250 geographically diverse ENTs was commissioned. 77% of the survey participants reported that they recommended nutritional supplements for patients presenting with either tinnitus or Meniere’s disease. More than 74% of those surveyed identified Lipo-Flavonoid® as the brand recommended most often.12
This wide acceptance of what was a previously unknown regimen was achieved primarily by the ENT professional community’s practice of sharing clinical observations relating to Meniere’s symptoms in published medical literature.
Before 1962 there were a number of treatment strategies being employed for treatment of ringing in the ears. In the more than 50 years since the pioneering work of Dr. Williams, many of those treatment strategies have been discredited and disappeared. Supplementation with Lipo-Flavonoid® however, has continued and is the recommendation of ever-increasing numbers of ENTs.
- Clarion and its immediate predecessor have provided thousands of ENTs in the United States with Lipo-Flavonoid® for their patients presenting with tinnitus in the last two years alone, always at the request of, or order from, the physician.
- The company which supplied Dr. Williams with product and had developed the original Lipo-Flavonoid® formulation was Smith, Miller and Patch of New York, New York.
- Williams, H.L. & Hedgecock, L.D. Citrus Bioflavonoids, Ascorbic Acid and Other B-vitamins in the Treatment of certain types of neurosensory deafness a preliminary report”. Staff meeting of the Mayo Clinic (1962)
- Williams, H.L. et al. “Eriodictyol glycoside in the Treatment of Meniere’s Disease”. Ann. Otol. Rhinol. Lar. (1963).
- See Shea, J.J. “The treatment of Meniere’s disease”, Miss. St. Med. Assoc. (1965), VI, 11, 411-414.
- Fahey, D. “Meniere’s disease – is surgery really necessary?”, Laryngoscope (1967), 77, 6, 918-930.
- Lipo-Flavonoid® is not a drug.
- Wolfson, R.J. “Treatment of Meniere’s disease”. Modern Treatment (1969) 6,3, 553-567.
- Rubin, W. “Vestibular suppressant drugs”. Arch. Otolaryngol (1973).
- Shaia, F.T. & Sheehy, J.L., “Sudden sensori-neural hearing impairment: a report of 1,220 cases”. Laryngoscope (1976); 86: 389-98.
- Slattery, W.H & Fayad, J.N. ”Medical Management of Meniere’s disease”. Otolaryngologic Clinics of North America”. (1997); 30:1027-37.
- Survey data on file.
Ishikawa, Y. Biophys Res Commun 2000, 279(2): 629-34. Fetterman, B.L., et al “Prognosis and treatment of sudden sensorineural hearing loss”. Am. J. Otol (1996); 17:529-36. Herschberg, S. “Meniere’s disease”. J. Am. Osteopathic Association, (1974); 73-540-6.